Sintomas específicos de ansiedade em crianças com asma: análise da concordância entre a percepção de crianças e seus pais/responsáveis

Abstract

Introduction: Asthma is one of the most common chronic diseases in the pediatric population, characterized by bronchial hyperresponsiveness and expiratory airflow variation. Associated with respiratory symptoms, there is a three times higher prevalence of anxiety disorders in children with asthma compared to healthy children. The problem is that anxiety in the pediatric asthma population is still underdiagnosed. Moreover, during the evaluation of these symptoms, the clinician does not seem to know which report to trust; parent / guardian or child. Studies reveal poor agreement between these reports. Objective: To evaluate the agreement between the perception of anxiety of children with asthma and the perception of their parents / guardians. Methods: This is an exploratory cross-sectional study. The sample consisted of children from 7 to 12 years old, of both sexes, diagnosed with asthma according to the Global Initiative for Asthma (GINA) criteria, and their respective parents / guardians. To assess specific anxiety symptoms in children and parents / guardians, respectively, the Spence Children’s Anxiety Scale (SCAS) and Spence Child Anxiety Scale for Parents (SCAS-P) were used. Data were analyzed using the Statistical Package for Social Science (SPSS) software version 23.0. To verify the agreement between children's perception and parents' perception, the Kappa coefficient was used. Results: the sample consisted of 42 children, with a mean age of 10.1 ± 1.6 years, male (59%); and 42 parents / guardians. Results were divided into six domains of SCAS following specific anxiety symptoms. Elevated anxiety, identified by total SCAS score analysis, was observed in 35.7% of the children evaluated and all had one or more anxiety symptoms. No statistically significant agreement was observed between the perception of children and parents in the symptoms of separation anxiety, panic attack, fear of physical harm and obsessive compulsive problems (p> 0.05) and there was poor statistically significant agreement in the symptoms of separation. social phobia (Kappa = 0.09 p = 0.04), generalized anxiety (Kappa = 0.12, p = 0.002) and total SCAS score (Kappa = 0.11, p = 0.001). Conclusion: There was poor agreement between the perception of children and parents about the specific symptoms of anxiety.